Alicia Jean Lane, MSN, RN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Dowagiac, MI
NPI 1154982783 · NPPES record last updated Aug 25, 2022
Key facts
- NPI
- 1154982783
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704343669 (MI)
- Practice address
- 520 Main St
Dowagiac, MI 49047-1762 - Phone
- (269) 783-3052
- NPI assigned
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ascension Medical Group Promed
Practice addresses (Care Compare)
7775 Angling Rd
Portage, MI 49024-7427
Phone (269) 321-7120
Hospital & facility affiliations
- Borgess Medical Center
- Bronson Methodist Hospital
- Beacon Plainwell
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220511001644 | MI | Practitioner - Nurse Practitioner | 1355728486 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Borgess Lee Hospital | Current |
Accepting new patients | |
| Promed Healthcare | Current |
Accepting new patients | |
| Theoria Medical | Nurse Practitioner | Current |
Accepting new patients |
| Ascension Medical Group Promed | Family | Current |
Accepting new patients |
| Ascension Borgess Lee Hospital | Current |
Accepting new patients | |
| Ascension Borgess Lee Hospital | Current |
Accepting new patients |
Locations
5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216
520 Main St
Ste A
Dowagiac, MI 49047
Phone (269) 783-3052
420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681
520 Main St
Dowagiac, MI 49047
Phone (269) 390-0536
3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300
1535 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5927
1535 Gull Rd
Ste 205
Kalamazoo, MI 49048
Phone (269) 381-3521
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
7775 Angling Rd
Portage, MI 49024
Phone (269) 321-7120
7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704343669 | MI | Yes |
Addresses
Primary practice location
520 Main St
Dowagiac, MI 49047-1762
Mailing address
1014 Westmoreland Ave
Kalamazoo, MI 49006-5544
Phone (517) 494-0833
Other practice location 1
1910 Shaffer St
Kalamazoo, MI 49048-1604
Phone (269) 382-9820
Other providers in Dowagiac, MI
- Lake Country Urology Clinic, PLLC
- Lakeland Community Hospital Watervliet
- Lakeland Community Hospital Watervliet
- Lakeland Immediate Care Center
- Lakeland Immediate Care Center
- Misty Rae Ledesma
- Lee Memorial Hospital
- Lee Memorial Hospital Corporation
- Lee Memorial Hospital Corporation
- Lee Memorial Hospital Corporation
All providers in Dowagiac, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.